When Architecture goes beyond the building, it promises dignity and comfort to the people it serves, and can have impact on a long term basis, educate and heal people. The Butaro Hospital in Rwanda is the built proof of such an ambitious vision.
In 2007, before the hospital was built, the entire district lacked a regional hospital. More specifically, the 320,000 inhabitants of Burera district remained without access to a basic health facility. The initiative to design a hospital in the area was taken by a non-profit organization, Partners-in-Health and the Rwanda Ministry of Health. They collaborated with the young students of Architecture, Michael Murphy and Alan Ricks who volunteered to implement the design and the on-site supervision of the construction. Since then, they created the MASS design Group along with an enthusiastic team of designers and architects. The project was supported financially by the Clinton foundation.
Traditionally, the Rwandan society has a patriarchal social structure that underlies the unequal social power relations between men and women, boys and girls2 .
The construction of the hospital gave the opportunity for this prejudice to be put aside, as women and men participated equally, in all parts of the construction. In several cases, women became the lead masons and were specifically asked to work in other parts of the area, after their skills became popular. Therefore, not only did the hospital initiate a serious boost in economic activity, but also helped raising the subject of gender equality which is a serious step forward for the local society.
In the area there is high prevalence of water and sanitation related diseases due to the lack of relevant facilities. The hospital has changed the daily life of the people to the best. The fact that the quality of health has been upgraded, is evident as now it is easier and cheaper to see a doctor and the rates of mortality of children under 5 years old have been dramatically reduced.
Poverty is identified as one of the biggest issues faced by women and men in Rwanda. More than 90% of the local economy is based on agriculture. The hospital has created more than 2,000 jobs related to construction and research. The local labor was a choice to fight unemployment and inject confidence and a sense of community to the people who worked for the same purpose. The training of the people who worked there has resulted in a domino effect for the future of the district. The local people were taught Diverse crafts, such as the masonry technique, or the compressed earth block creation. Therefore more and more people became able to afford the education of their children and improve their daily life.
From a sustainable aspect, local materials were used and no extra transfer costs or severe interventions were necessary, as most of the building components were made by hand and the use of simple tools and techniques.
The community of trainers and medical staff is a positive sign that a scientific hub has started to shape. These people will be able to produce research and spread knowledge.
Due to the area’s earthquake activity a strong foundation was necessary for the hospital. A lot of attention and time was given to the excavation and the construction of the foundations, as the ground base is rocky and difficult to dig more than one meter deep.
Nevertheless, the volcanic stone of the area proved an ideal solution to the cladding of the walls. The material is in great abundance in the area, therefore is financially sustainable. Parts of the facades were cladded with these stones in a jigsaw technique which had never been applied before in the area; the technique required the minimum amount of mortar, but also skillful labor as the stones needed to match perfectly to form the masonry. This locally produced masonry of the wards and the treatment centers give a unique identity that integrates it with the rough landscape. The most impressive thing to know was that women of the area helped building these walls, with exceptional skills that made them popular around the area.
The climate of the District is wet, characterized by two dry seasons and two rainy seasons. Annual precipitations reach 1400 mm; the temperature varies between 9 oC and 29 oC, according to the season.
The District of Burera belongs to the agro-bioclimatic zone of highlands of Buberuka and highlands of Lave with an average altitude of 2100 meters. Its landscape is characterized by steeply sloping hills connected either by valleys steep sided or by flooded marshes. 3
The area’s main landmark is the active volcano Muhabura, which was also the source of the hospital’s beautiful masonry. Therefore the environment can be defined as rather rural and relatively natural.